ArticleMedicine2025
Malignant hypertension-induced multiorgan failure and acute limb ischemia in a young adult: A case report.
Article in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
rationaleMalignant hypertension (MHT) is characterized by a systolic blood pressure (BP) of ≥ 180 mm Hg and/or a diastolic BP of ≥120 mm Hg, accompanied by acute target organ damage. While it often results in multiorgan failure, the development of a left ventricular (LV) thrombus and subsequent acute limb ischemia (ALI) is rare. PATIENT CONCERNS: A 26-year-old Korean male with untreated hypertension presented with MHT and discoloration of the right lower extremity. The affected limb exhibited classic signs of ALI. DIAGNOSES: Computed tomography angiography revealed a right renal infarction and total occlusion of the right distal superficial femoral artery. Echocardiography demonstrated a reduced ejection fraction of 32% and a LV thrombus. Hybrid 18-fluoro-deoxyglucose (FDG) positron emission tomography/magnetic resonance imaging revealed no abnormal FDG uptake or late gadolinium enhancement, ruling out myocardial inflammation, fibrosis, or scarring and confirming MHT as the cause of LV dysfunction and thrombus.
interventionsThe patient underwent percutaneous transluminal angioplasty and Fogarty embolectomy, successfully restoring blood flow. Fasciotomy was performed to manage reperfusion injury. OUTCOMES: The symptoms and blood flow in the right lower extremity were restored. Follow-up echocardiography showed an improved ejection fraction of 50% and resolution of the LV thrombus. The patient continued to improve, was discharged, and is currently undergoing rehabilitation therapy. LESSONS: Hypertension should be proactively managed to prevent life-threatening complications. Timely intervention, particularly in cases of severe complications, is essential for optimizing patient outcomes.
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